Ukwelashwa kwezifo eziningi zezinso kanye nemisipha yenhliziyo, umfutho wegazi ophakeme kanye nezinye izindlela, kusetshenziswa izidakamizwa ezikhethekile, eziqukethe ama-inhibitors we-eni ye-engiotensin-converting. Lo muthi ungenye ephumelela kakhulu. Kusetshenzisiwe hhayi ngezinjongo zokwelapha kuphela, kepha futhi nokuvikela izinhlobo ezahlukahlukene zezinkinga (isibonelo, unhlangothi kanye nokuqunjelwa kwe-myocardial).
Igama
Igama lokuhweba - Hartil Am. Igama ngesiLatini nguHartil. INN - URamipril.
IHartil ingenye yezindlela eziphumelela kakhulu zokwelapha izifo eziningi zezinso kanye nemisipha yenhliziyo, umfutho wegazi ophakeme nezinye izifo.
I-ATX
Ukuhlukaniswa kwe-ATX: iRamipril - C09AA05.
Khipha amafomu nokwakheka
Umuthi wenziwa ngesimo samaphilisi okusaqanda o-orange-pink no pink (5 mg) noma umbala omhlophe (10 mg). Into esebenzayo yesidakamizwa i-ramipril. Izingxenye ezisizayo:
- i-iron oxide;
- i-lactose monohydrate;
- isitashi;
- i-sodium bicarbonate.
Umuthi wenziwa ngesimo samaphilisi okusaqanda o-orange-pink no pink (5 mg) noma umbala omhlophe (10 mg).
- Isenzo se-Pharmacological
Umuthi unomphumela we-hypotensive. Ayithinti kuphela igazi, kodwa nezicubu ngisho nezindonga zemithambo yegazi.
Umuthi ubuyekeza ukuphuma kwenhliziyo, wehlise ingcindezi emithanjeni yamaphaphu, unciphise umfutho wegazi futhi uvimbele nemithambo yegazi.
Umphumela we-antihypertensive ubonwa emahoreni angama-1-2 ngemuva kokuthatha umuthi, kepha ufinyelela umsebenzi ophakeme ngemuva kwamahora angama-3-6 futhi uqhubeka usuku.
Inkambo yokwelashwa ngemithi isiza ukuqinisa umfutho wegazi emasontweni ama-3-4 wokusebenzisa.
I-Pharmacokinetics
Ngemuva kokuphathwa komlomo umuthi, izithako zawo ezisebenzayo nezisizayo zidonswa emgudwini we-gastrointestinal. Ukuhlushwa okuphezulu ku-plasma yegazi kufinyelelwa kungakapheli imizuzu engama-60-70 ngemuva kokuphathwa.
Umuthi wenziwa ngesisekelo ikakhulukazi esibindini ngokukhishwa kwama-metabolites (angasebenzi futhi asebenzayo). Umuthi ukhishwa ngemfucumfucu (40%) nomchamo (60%).
Izinkomba zokusetshenziswa
Imiyalo yomuthi ikhombisa izinkomba ezinjalo:
- ifomu elingapheli lokwehluleka kokuqina kwemisipha yenhliziyo (ikakhulukazi ngemuva kokuqothuka kwe-myocardial);
- i-arterial hypertension;
- isifo sikashukela se-nephropathy;
- Izinhlobo ezingamahlalakhona zesifo se-reuse.
Umuthi unciphisa amathuba okuba nesifo sohlangothi, ukufa kwe-myocardial kanye "nokufa kwe-coronary."
Contraindication
Imikhawulo ekusebenziseni isidakamizwa:
- ukungabekezelelani ngakunye;
- ukucaphuna nokukhulelwa;
- iminyaka engaphansi kweminyaka eyi-18;
- i-pathology yegazi;
- umfutho wegazi ophansi;
- udlulise i-angioedema;
- i-renal artery stenosis;
- ukukhuphuka kwe-aldosterone (hyperaldosteronism).
Ukukhulelwa kungenye yezimpawu eziphikisayo ekusebenziseni umuthi.
Ngokunakekela
Ngaphansi kokubhekwa ngokucophelela kwezokwelapha, umuthi ungathathwa kulezi zimo ezilandelayo:
- i-mitral noma i-aortic stenosis;
- izindlela ezinobungozi bokuqina komfutho we-arterial;
- i-angina pectoris engazinzi;
- ukwehluleka kwesibindi / kwezinso;
- isifo sikashukela mellitus;
- emva kokufakwa kwezinso;
- iziguli esezikhulile, njll.
Iziguli esezikhulile kufanele zisebenzise lo muthi ngokuqapha.
Ungayithatha kanjani iHartil
Isichasiselo kulo muthi sithi kufanele sidliwe ngaphakathi, i.e. ngomlomo, ngaphandle kokudla. Kuyinto engathandeki ukuhlafuna amaphilisi. Umthamo ukhethwa ngudokotela ngawodaba ngalunye. Kodwa-ke, kukhona imithamo emaphakathi yesidakamizwa:
- i-arterial hypertension: ekuqaleni kuka-2,5 mg umuthi unqunyelwe ngosuku, khona-ke umthamo uyandiswa;
- ukwehluleka kwenhliziyo okungapheli: 1.25 mg ngosuku;
- ukululama ngemuva kwe-infyoction ye-myocardial: umthamo wokuqala - amaphilisi ama-2 we-2,5 mg izikhathi ezi-2 ngosuku (kuyadingeka ukuqala ukuthatha umuthi ezinsukwini ezi-2-9 emva kokuhlaselwa);
- i-nephropathy: 1.25 mg / usuku;
- ukuvimbela ukufakwa kwe-myocardial infarction, unhlangothi kanye nokunye ukuphazamiseka kohlelo lwezinhliziyo: 2,5 mg / ngosuku.
Umthamo omkhulu womuthi ngu-10 mg ngosuku.
Isichasiselo kulo muthi sithi kufanele sidliwe ngaphakathi, i.e. ngomlomo, ngaphandle kokudla.
Ngoshukela
Iziguli ezinesifo sikashukela eziphuza umuthi zidinga ukulawula ushukela wazo. Uma kunesidingo, udokotela angalungisa umthamo we-insulin.
Imiphumela emibi
Lapho usebenzisa umuthi kunobungozi bokubonakaliswa okungekuhle. Kukhona eziningi zazo, ngakho-ke lolu daba kufanele lufundwe kusengaphambili.
Amapheshana wesisu
Imiphumela elandelayo emibi iyaphawulwa:
- isifo sohudo
- ukuhlanza
- isicanucanu
- i-cholestatic jaundice;
- i-pancreatitis
- Ubuhlungu besisu, njll.
Kusukela kwipheshana lesisu, imiphumela emibi ngendlela yesicanucanu nokuhlanza kungenzeka.
Izitho zeHematopoietic
Kubonwe:
- leukocytopenia;
- i-anemia
- i-thrombocytopenia;
- indlela ye-hemolytic ye-anemia;
- i-agranulocytosis;
- ukwehla kwenani lamaseli abomvu egazi;
- ukucindezelwa kwe-hematopoiesis yamathambo.
Isistimu yezinzwa ephakathi
Ukusabela okuhlukile kungokulandelayo:
- ikhanda
- Isiyezi
- izicubu zomsipha;
- iminyakazo
- ukuphazamiseka komoya okucindezelayo;
- ukukhathazeka kokulala;
- ukukhuphuka kokukhathazeka;
- ukushintshwa kwemizwa ebukhali;
- ukwehluleka.
Ubuhlungu bekhanda bungeminye yemiphumela emibi engenzeka.
Kusuka ohlelweni lwezitho zofuzo
Okulandelayo kuyaphawulwa:
- ukungabi namandla
- kwehla i-libido;
- ukukhuphula ukwehluleka kwezinso;
- ukuvuvukala kobuso, imilenze nezingalo;
- oliguria.
Kusuka ohlelweni lokuphefumula
Isiguli singaphazamiseka:
- ukukhwehlela nomphimbo obuhlungu;
- ukugoba kwe-bronchial;
- i-bronchitis, i-laryngitis, i-sinusitis, i-rhinitis;
- ukuphefumula.
Njengomphumela oseceleni wepheshana lokuphefumula, kungahlehlela ukukhwehlela owomile.
Allergies
Ukuphendula okungalungile kube nokuboniswa okulandelayo:
- ukuqhuma kwesikhumba nokulunywa;
- i-conjunctivitis;
- i-photosensitivity;
- indlela yokwaliwa yi-dermatitis ;;
- Idumela likaQuincke.
Imiyalo ekhethekile
Lapho usebenzisa amaphilisi, iziguli zidinga ukubhekwa ngokucophelela kwezokwelapha. Lokhu kuyiqiniso ikakhulukazi ngezinsuku zokuqala zokudla kwabo. Kungakapheli amahora angama-8 ngemuva kokusetshenziswa, kuyadingeka ukukala umfutho wegazi njalo.
Ngaphambi kokusebenzisa umuthi, udinga ukuguqula ukomisa kanye ne-hypovolemia.
Iziguli ezine-pathologies ye-vascular ezinso, ezinokulimala komsebenzi wezinso nangemva kokufakelwa kwezitho zidinga ukuqapha ngokucophelela kwezinkomba zokwelashwa.
Iziguli ezine-pathologies ye-vascular ezinso, ezinokulimala komsebenzi wezinso nangemva kokufakelwa kwezitho zidinga ukuqapha ngokucophelela kwezinkomba zokwelashwa.
Umthelela ekhonweni lokulawula izindlela
Ukwehla komfutho wegazi ezigulini ezisebenzisa lo muthi, kungakuhle ngazo ukuba zilahle ukuphathwa kwezokuhamba komgwaqo namanye amadivaysi ayinkimbinkimbi emishini.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Kwenqatshelwe ukusebenzisa umuthi ngesikhathi sokukhulelwa, ngoba into yayo esebenzayo ingathinta kabi ukukhula kwesibeletho. Ngokukhishwa kwesisu nokuqokwa komuthi, ukuncelisa ibele kufanele kumiswe.
Ukuqokwa kukaHartil ezinganeni
Kwenqatshelwe ukusebenzisa umuthi ezigulini ezingaphansi kweminyaka engu-15. Kuze kube iminyaka engu-18, lo muthi uphuza imithamo engaphansi nangaphansi kokuqashwa osondelene nodokotela.
Kwenqatshelwe ukusebenzisa umuthi ezigulini ezingaphansi kweminyaka engu-15.
Sebenzisa ebudaleni
Ezigulini esezikhulile, umuthi ubekiwe uma kungekho okubhekwayo nemithamo engasho lutho. Uma kusetshenziswa noma isiphi isisu, umthamo kufanele ukhethwe ngokunakekelwa okuthile.
Ukweqisa
Uma umthamo womuthi wedluliwe, ukubonakaliswa okunjalo okungalungile kungabhekwa:
- ukwehluleka ebhalini le-electrolyte;
- ukuncipha kwengcindezi yegazi;
- ukuthuthukiswa kokuhluleka kwezinso.
Nge-overdose encane, isiguli sidinga ukuhlanza isisu, kanye nokuphuza i-sodium sulfate nama-enterosorbents.
Ezimpawu ezibucayi kanye nokwehla okukhulu komfutho wegazi, kuboniswa ukusetshenziswa kwe-angiotensin ne-catecholamines. I-Hemodialysis ene-overdose ayisebenzi.
Ukuxhumana nezinye izidakamizwa
Lapho uhlanganisa umuthi ne-procainamide, i-corticosteroids, i-allopurinol, i-hydrochlorothiazide derivatives kanye nezinye izinto ezibangela ushintsho ekwakhekeni kwegazi, amathuba okuthi kube nezinkinga ezenzeka ohlelweni lwe-hematopoietic luyanda.
Lapho uhlanganisa umuthi nama-ejenti we-hypoglycemic, kunobungozi bokwehlisa ushukela wegazi kanye nokulimala kwesibindi emsebenzini.
Kuyinto engathandeki ukusebenzisa ama-diuretics kanye ne-potassium salt substitutes ngasikhathi sinye nalo muthi ngenxa yokuqhamuka ne-hyperkalemia. Ukwelashwa nge-ACE inhibitor kufanele kwenziwe ngaphansi kokubhekwa kwezokwelashwa okuseduze.
Ukuhambisana notshwala
Ngenxa yokuthi into esebenzayo yesidakamizwa iyakwazi ukuthuthukisa ithonya le-ethanol, kwenqatshelwe ukuphuza utshwala nemithi equkethe utshwala lapho uthatha umuthi. Okushiwo okufanayo emiyalweni yokusetshenziswa kwomuthi.
Into esebenzayo yesidakamizwa iyakwazi ukuthuthukisa umphumela we-ethanol, kwenqatshelwe ukuphuza utshwala lapho uthatha umuthi.
Umkhiqizi
Inkampani yaseMalta i-ACTAVIS noma inkampani yezokwelapha i-Icelandic i-ACTAVIS hf. Isethulo - I-EGIS CJSC "Ibhizinisi Lezemithi".
Ama-Analog
Izithonjana zamaRussia ezifinyeleleka kalula:
- Amaphiramidi;
- I-Amprilan;
- Wazolong;
- Amlo;
- URamipril;
- Umkhondo;
- ERamicardia;
- I-Dilaprel, njll.
Imibandela yekhefu lekhemisi
Ungathenga umuthi cishe kunoma iyiphi ikhemisi.
Ungathenga umuthi cishe kunoma iyiphi ikhemisi.
Ngingakwazi ukuthenga ngaphandle kadokotela
Ungathenga amaphilisi kuphela ngencwadi kadokotela.
Intengo yeHartil
Izindleko zepakethe elilodwa lomuthi ezivela ezibhebheni ezingama-28 ziqala kusuka kuma-ruble angama-460.
Izimo zokugcina zomuthi
Umuthi ugcinwa endaweni eyomile futhi emnyama. Umbuso wokushisa omuhle yi- + 15 ... + 25 ° C.
Isikhathi sokuphelelwa yisikhathi
Kufika eminyakeni emi-2 ngemuva kokwenza.
Ukubuyekezwa mayelana neHartil
Umuthi uphendulwa kakhulu ohlangothini oluhle. Lokhu kungenxa yezindleko ezingabizi kanye nezinga eliphakeme lokusebenza kwayo.
Izazi zezenhliziyo
U-Ivan Korkin (udokotela wenhliziyo), oneminyaka engama-40, uVoronezh
Ngikhipha umuthi wokuthola umfutho wegazi ophakeme, ukwehluleka kwenhliziyo, namanye ama-pathologies amaningi. Ukugwema imiphumela emibi, kufanele ukhethe kahle umthamo.
U-Inga Klemina (udokotela wenhliziyo), oneminyaka engama-42 ubudala, eMoscow
Umuthi kudala ufunwa phakathi kweziguli zami. Naye uqobo wayisebenzisa ukuvimba ukuthuthukiswa kwe-myocardial infarction. Njengoba unikezwe umsebenzi wezithako ezisebenzayo zesidakamizwa, ukufeza umphumela wokwelapha, imithamo kufanele ikhethwe kuphela ngemuva kokuhlolisisa kahle isithombe somtholampilo se-pathology esigulini.
Iziguli
UVladislav Pankratov, oneminyaka engama-36, uLipetsk
Nginenkinga yesifo sikashukela esincike ku-insulin, okungenye yezinkinga ezikhona yi-hypertension. Udokotela ubeke la maphilisi. Bengilokhu ngizithatha izinyanga ezingaba ngu-2,5. Ukuthuthuka kuyabonakala, kepha muva nje sekuqala ukuzizwa unesiyezi ngokuhamba amabanga amade. Ngizoya esibhedlela ukuyobonisana.
U-Elvina Ivanova, oneminyaka engama-45, uVladivostok
Lapho umfutho wegazi wami uqala “ukugxuma”, udokotela wanikeza umuthi umuthi. Wazizwa engcono cishe amasonto amabili ngemuva kokuqala ukwelashwa. Manje sengibemukela ngezinjongo zokuvimbela.
